Opioid-induced bowel dysfunction in cancer-related pain: causes, consequences, and a novel approach for its management

Opioids are the mainstay of management for patients with cancer-related pain. Although the analgesic efficacy of opioid therapy is well documented, the recent European Pain in Cancer survey demonstrated that the management of moderate-to-severe pain in patients with cancer is far from optimal. Bowel...

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Bibliographic Details
Published in:	Journal of opioid management Vol. 5; no. 3; p. 145
Main Authors:	Holzer, Peter, Ahmedzai, Sam H, Niederle, Norbert, Leyendecker, Petra, Hopp, Michael, Bosse, Björn, Spohr, Ingrid, Reimer, Karen
Format:	Journal Article
Language:	English
Published:	United States 29-01-2018
Subjects:	Analgesics, Opioid - adverse effects Analgesics, Opioid - therapeutic use Clinical Trials as Topic Constipation - chemically induced Constipation - prevention & control Drug Therapy, Combination Humans Naloxone - therapeutic use Narcotic Antagonists - therapeutic use Neoplasms - complications Oxycodone - adverse effects Oxycodone - therapeutic use Pain - drug therapy Pain - etiology Quality of Life Severity of Illness Index
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Summary:	Opioids are the mainstay of management for patients with cancer-related pain. Although the analgesic efficacy of opioid therapy is well documented, the recent European Pain in Cancer survey demonstrated that the management of moderate-to-severe pain in patients with cancer is far from optimal. Bowel dysfunction, and importantly constipation, is a common side effect and has a significant impact on the patient's morbidity and quality of life. Nonpharmacological strategies and laxatives are often not effective in the management of opioid-induced constipation (OIC), making it necessary to search for new strategies for the treatment of opioid-induced bowel dysfunction. One promising strategy is the prevention of OIC with peripherally acting opioid antagonists that specifically target the underlying cause of this condition, without affecting centrally mediated analgesia. In recent studies, the novel combination of prolonged-release oral oxycodone and prolonged-release oral naloxone provided effective analgesia with improved bowel function in patients suffering from severe cancer-related and noncancer-related pain. The combination has the potential to improve the quality of pain management significantly in these patients.
ISSN:	1551-7489
DOI:	10.5055/jom.2009.0015